Actuarial Director, Pricing

🔥 13 hours ago

🍑 Georgia – Remote

🍑 Georgia – Remote

💵 $127.3k - $216.5k / year

⏰ Full Time

🔴 Lead

📊 Actuary

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PacificSource Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Direct all actuarial pricing and related services • Ensure accurate and reliable actuarial activities and sound actuarial analysis of risk • Develop commercial premium rates and Medicare Advantage bids • Prepare rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and statements of opinion • Direct development, implementation, and maintenance of commercial rating and pricing models • Support reserving, forecasting, budgeting, risk adjustment, risk sharing, premium deficiency reserve, and year-end actuarial opinion processes • Direct analysis of risk, cost, and utilization with the Actuarial Director of Health Economics • Lead and supervise actuarial students, credentialed actuaries, and non-actuarial analysts • Assist with hiring, staff development, coaching, performance reviews, corrective actions, and employee termination • Maintain awareness of actuarial curriculum and requirements and update the student program • Assist in department budget development • Coordinate with Underwriting, Product Development, Sales, and Finance • Participate in strategic and internal committees • Support Medicare Advantage and Commercial P&L owners on operational and strategic initiatives • Lead process improvement and promote lean methodologies • Participate in PacificSource research activities • Follow privacy policy and HIPAA confidentiality and security requirements • Meet department and company performance and attendance expectations • Perform other duties as assigned

🎯 Requirements

• At least six years actuarial experience required • Three years management experience required • Health experience preferred • Baccalaureate degree in mathematics, statistics, actuarial science, or a related field • Enrolled as an Associate or Fellow in Society of Actuaries • Active member in good standing of American Academy of Actuaries • Ability to apply actuarial methods and modeling techniques • Adherence to Actuarial Standards of Practice • Ability to accomplish tasks accurately under pressure, determine priorities, and meet deadlines • Ability to identify and define problems, design and implement solutions, and monitor results • Ability to read and comprehend written and spoken English • Ability to communicate clearly and effectively

🏖️ Benefits

• Equal opportunity employment • Travel approximately 5% of the time

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